DrillCut TM vs VersaCut TM prostate tissue morcellation devices after holmium laser enucleation: A prospective, randomized controlled trial.

INTRODUCTION: We aimed to compare efficacy, safety, and cost of disposables of the DrillCutTM morcellator with the VersaCutTM morcellator after holmium laser enucleation of the prostate (HoLEP).

METHODS: After obtaining ethical approval, consecutive patients undergoing HoLEP for symptomatic benign prostatic hyperplasia were randomized to have their enucleated prostates morcellated by either Karl Storz® DrillCutTM or Lumenis® VersaCutTM morcellators. All procedures were performed by two experienced urologists. Patients' demographics and perioperative data were recorded. Both morcellators were compared for their safety, efficacy, and cost-effectiveness.

RESULTS: Eighty-two patients were included in the study (41 per each arm). Both groups were comparable in terms of age, preoperative prostate size (114 vs. 112 mL; p>0.05), enucleation time (95.3 vs. 91.7 minutes; p>0.05), and morcellation time (22.6 vs. 17.3 minutes; p>0.05). The DrillCutTM was associated with significantly lower morcellation rate when compared with the VersaCutTM (3.6 vs. 4.9 g/min; p= 0.03). In terms of safety, there was no significant difference between both morcellators in complication rates (2.4% vs. 7.3 %; p=0.1). However, there was one case of bladder perforation requiring exploration with the VersaCutTM . The DrillCutTM was associated with significantly higher cost of disposables when compared with the VersaCutTM ($247.5 vs. $160.9; p<0.01).

CONCLUSIONS: Despite the small sample size, the DrillCut™ was associated with lower morcellation rate when compared with the VersaCutTM . However, this difference may not be clinically significant. Although both morcellators were comparable in their safety, the DrillCutTM was associated with higher cost of disposables when compared with the VersaCutTM .